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April 2017
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At first glance, the definition of a cross-dressing fetish would appear to combine the behaviour of a person who wears clothes of the opposite sex – cross-dressing – and who pays particular attention to the significant parts of the chosen clothes so as to use them as a sexually and erotic way to express themselves, as is the cases for fetishes.
In reality, in the international classification of paraphilia, the main reference manuals (DSM-IV-TR and ICD-10) highlight that there is a semantic problem associated with the cross-dressing culture. In order to make the definition as clear and simple as possible, we need to start with an introduction that defines and distinguishes a cross-dressing fetish from all other possible variations of cross-dressing.

Terms and terminology
When the term ‘transvestite’ was coined in the last century, it essentially referred to a person who wore clothes of the opposite sex, and it usually referred to men who dressed up as women. From that point on, ‘cross-dressing’ has been used to describe different types of cross-dressing behaviour without focusing on anything else, that is, why it is done. This meant that a stereotype was born and has grown which causes confusion and social ignorance.
In fact, the intuitive concept of cross-dressing includes various types of behaviour which must be explained more precisely, thus it is fundamental that we refer to three basic concepts of human sexuality: gender identity, gender role and sexual orientation.
With gender identity we mean the feeling felt by a person towards his/her biological sex. Gender role, on the other hand, refers to the representation of everything a person says or does to show others, and him/herself, how much he/she belongs to the female or male gender. Lastly, sexual orientation refers to the way a person responds erotically and sexually to various sexual stimuli coming from the partner. Sexual orientation can be heterosexual, homosexual or bisexual.
These sub-areas of sexual orientation merge and perfectly combine themselves with the biological sex of a person, thus forming the sexual identity of each individual.

With these definitions we can now distinguish the following:

a) A transsexual, who, today, is defined from a medical and scientific point of view as person who suffers from Gender Identity Disorder. These individuals, both men and women alike, do not feel happy with the sex they were assigned at birth so they embark on medical and hormonal or psychological, behavioural and social relation programmes so as to ‘transform’ into the opposite sex. A man who wants to match his physical identity with his mental identity is called a MtoF (male to female), whilst a woman who does the opposite is called a FtoM (female to male). The use of clothing belonging to the opposite sex becomes of paramount importance and use for transgender individuals as it allows them to comply with and represent their desired gender identity. Transsexuals usually cross-dress regardless of whether they have had sexual reassignment surgery (SRS), such as when they have to cross-dress during the Real Life Experience period. It is therefore clear to see that gender role and gender identity are usually egodystonic (not consistent with one's image and perception of self), however, sexual orientation tends to be heterosexual according to the desired gender. As far as transsexuals with homosexual orientation are concerned, the appropriate term to use is transhomosexuality.

b) A transgender individual. This is a person (male or female) who is usually satisfied with his/her sex but who prefers to take on the social role of the opposite sex and behaves like the opposite sex in an overt way. In this case, gender identity conforms with the individual’s biological sex but gender role is egodystonic as far as the social context of reference is concerned. A transgender person does not want to undergo SRS but he/she does tend to do things to appear more convincing socially; for instance, cross-dressing, undergoing cosmetic surgery (of the lips, cheeks, breasts, buttocks, and so on) and undergoing hormonal therapy (often without the supervision of a doctor). Sexual orientation is usually homosexual, but there are some transgender men who call themselves bisexual. Often, for fear of having to face SRS, some transsexuals decide to remain in a state of 'transition' (as transgender individuals) even though their gender identity does not comply with the identity they feel and desire.

c) Androgynes: this is a person (male or female) who is satisfied with his/her biological sex and, thus, also his/her gender identity. The person’s gender role is egosyntonic, that is, he/she behaves in a way that is coherent to the gender identity he/she feels and lives with. The only element that makes an androgyne stand out is the perception that others and society could have towards his/her way to dress and/or behave. In fact, androgynes also cross-dress so as to be psychologically and socially satisfied; for example, a woman might decide not to wear a piece of clothing that is characteristically female, or a man might decide to wear earrings or pluck his eyebrows. More often, however, these androgenic features are representative of current trends and fashions. An androgyne can be heterosexual, homosexual or bisexual.

d) Gender Mimic: this is a person (male or female) whose gender identity and gender role are egosyntonic however he/she behaves in certain ways, such as cross-dressing, in order to perform in a show, such as a theatrical or televised show or performance in a nightclub as a drag queens and drag king. A gender mimic’s sexual orientation can be heterosexual, homosexual or bisexual.

e) Transvestite homosexuals: even though these individuals, who are mainly males, do agree with their biological sex, they wear clothing and use items that belong to the other sex, thus cross-dressing. The representation of a transvestite homosexual’s social role is reversed and, of course, the orientation is homosexual. These individuals tend to impose their past experiences, which have often involved homophobic experiences, on themselves by highly exaggerating the physical appearance of the opposite sex. Integration of transgender individuals and gender mimics is exemplified by the film ‘La Cage aux Folles’ (The Birdcage) starring Ugo Tognazzi and Michel Serrault, in which Alben, who is expressly homosexual, lives dressed as a woman, although he does not perceive that he has a gender identity disorder, and he works in the evening as a drag queen in shows in nightclubs. From a clinical point of view, transvestite homosexuals could appear confused and could call themselves transsexuals and this element is of fundamental importance as any step towards a sex change, if taken, could cause psychological and emotional problems and general feelings of discomfort in the individual.

f) Viados. This word stems from the Brazilian slang for deer (veado) and it is usually associated with a vulgar term for homosexual. Viados are South American men who wear female clothing and who undergo cosmetic surgery (breast transplants, rhinoplasty, liposuction, and so on) and hormone therapy for lucrative means; for instance, prostitution. Gender identity is ‘confused’ and the gender role is reversed, whilst sexual orientation is usually homosexual or bisexual. Quite often viados suffer from Gender Identity Disorder thus they turn to SRS, however others, on reaching their financial objectives, go back to their native country and return to their former lives, which may include wives and children.
In all of the abovementioned categories, the individuals all cross-dress, thus they are all cross-dressers, however the reason why they do is different in each case.

The terms transvestite and cross-dresser are, therefore, incorrectly associated with a cross-dressing fetish, as this actually represents a person (usually a man) who, regardless of his/her gender and sexual orientation, cross-dresses in order to be aroused or satisfy erotic or sexual desires, and usually with a partner of the opposite sex (usually a female).

A cross-dressing fetish in the DSM IV-Tr refers to reoccurring fantasies and sexual impulses and behaviour and intense sexual excitement in the face of a heterosexual man dressed as a woman. However, even though this refers to a heterosexual man, some authors have noted that there are some, although only a small percentage, of homosexual, bisexual and even asexual men who cross-dress.
It must be reiterated that the reason behind cross-dressing is erotic and sexual excitement, and this behaviour can vary widely, ranging from wearing a small piece of female underwear under a suit (knickers, stockings, etcetera) to dressing as and wearing make-up like a woman in public. It must also be noted that this behaviour does not necessarily causes clinical problems, distress or harm to the individual.

Deviance and/or disorder
When defining a cross-dressing fetish, it is fundamental to keep in mind the behavioural characteristics of a deviance and a disorder. Cross-dressing, as described above, actually encompasses a large range of different types of behaviour which can be placed on a continuum that runs from not sexual, for example, wearing a kilt, to sexually deviant and disturbed, as is the case when men steal clothes from females so as to sexually satisfy himself by wearing the clothes. We must also keep in mind factors relating to time, everything concerning the evolution of mankind and different cultures, since wearing of clothes that are today considered to be female may no longer be acceptable, but, once upon a time, it was. When contextual and motivational factors are considered together with this continuum, it is clear to see that not all cases of cross-dressing are deviant and they may even represent a deep problem that the cross-dressed individual has inside of him/her.
It appears useful, therefore, to remember that all forms of cross-dressing may represent characteristics of deviance and/or a disorder in as much as they can also be possible forms of psychological and social adaptation.
Furthermore, as far as a cross-dressing fetish is concerned, which is usually considered to be a form of paraphilia and thus it is listed in the DSM IV-Tr as a mental disorder, it is possible to make a distinction between dysfunctional behaviour (a disorder) and a transgressive experience shared with a partner. In fact, Wheeler et al. underlined the importance of redefining this difference between a sexual deviance and a paraphiliac disorder: we can talk about a cross-dressing fetish disorder when individuals live in a state of psychological, emotional and social distress, whilst a cross-dressing fetish regards any other form of transgressive cross-dressing that is, usually, shared with a partner.

Clearly and precisely interpreting the characteristics associated with cross-dressing allows us to not only understand the emotional, affectionate and social aspects of this behaviour, but also, and more importantly, redefine the stereotypical concept of being ‘different from me’, thus enhancing concepts of normality, deviance, a disorder/paraphiliac and transgression. Having a better understanding of this means that these people have a better quality of life and that ignorance can be overcome.


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